Unexpectedly, occupations categorized as “health,” “teach,” “bank,” and “admin” were associated with significantly higher MOR; whereas “fire” (firefighting) was not. Women with “admin” and “bank” employment histories had the highest MOR compared with men. The explanation for this observation may primarily relate to genetics; however, it is interesting to speculate that associated lifestyle differences, such as the routine use of hairspray or cosmetics, could play a role, such as was previously reported.,, On the other hand, the finding of no significant MOR increase in the “fire” category is somewhat unexpected given the well-documented cases of new-onset pulmonary sarcoidosis following a large, acute exposure to smoke, dust, and fumes during the September 11, 2011, catastrophe in New York City; especially among black firefighters. It is interesting to speculate that the form of sarcoidosis that develops in response to a single, large exposure to antigen is phenotypically distinct from sarcoidosis that develops after multiple, less-intense exposures. Indeed, one of the previously mentioned cases of possible hairspray-associated pulmonary sarcoidosis completely resolved after the patient was removed from her occupational environment. Thus, prolonged or repeated occupational exposures may be required for the development of more severe sarcoidosis phenotypes, such as those leading to premature death. Unfortunately, the duration or intensity of the occupational exposures was not apparent from the information provided in the death certificates used for the study by Liu et al.